Mycobacterium paratuberculosis, the causative agent of Johne's disease (a chronic enteritis in ruminants), has been suspected to be involved in Crohn's disease. In this study, polymerase chain reaction was used to detect the presence of IS900 DNA sequences specific to M. paratuberculosis genomes in biopsies and surgical resections from 53 children with various gastrointestinal diseases and disorders. IS900 sequences were found in 13 of 18 samples from patients with Crohn's disease (72%; P < .01 vs. samples from patients without Crohn's disease), in 1 of 5 with ulcerative colitis, in 2 of 6 with severe unclassified colitis, and in 7 of 24 with other gastrointestinal illnesses. These results appear to support the hypothesis that M. paratuberculosis is involved in the pathogenesis of Crohn's disease.

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Thirteen children, aged 2 to 16 years, had a subtotal resection of small bowel, following a mid‐gut volvulus in 10 cases. All children are alive, and their growth is normal; 36 cumulative patient‐years of parenteral nutrition and 11 years of constant‐rate enteral nutrition were performed. In 7 cases, in which residual small bowel varied between 30 to 120 cm, termination of all artificial nutritional support was possible 30 months in mean after intestinal resection. In contrast, if resection was near total with less than 20 cm remaining, life‐long dependence on parenteral nutrition is unavoidable unless intestinal transplantation becomes feasible. With cyclic parenteral nutrition at home, the patients' quality of life is near normal.

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